Table 3.
Summary of evidence-based guidelines for chemotherapy-induced nausea and vomiting (CINV) prophylaxis with intravenous chemotherapy.
| Emetic risk category | Guideline recommendation |
|---|---|
| High (including AC combinations) | NK-1 receptor antagonist + 5-HT3 receptor antagonist + dexamethasone (Hesketh et al., 2016b; MASCC/ESMO, 2016; National Comprehensive Cancer Network, 2016) or Olanzapine + 5-HT3 receptor antagonist + dexamethasone (National Comprehensive Cancer Network, 2016) |
| Moderate | 5-HT3 receptor antagonist + dexamethasone (± NK-1 receptor antagonista) (Basch et al., 2011; National Comprehensive Cancer Network, 2016) or Olanzapine + 5-HT3 receptor antagonist + dexamethasone (National Comprehensive Cancer Network, 2016) or 5-HT3 receptor antagonist + dexamethasone (MASCC/ESMO, 2016) |
| Low | Dexamethasone (Basch et al., 2011; MASCC/ESMO, 2016; National Comprehensive Cancer Network, 2016) or Dopamine receptor antagonist OR 5-HT3 receptor antagonist (MASCC/ESMO, 2016; National Comprehensive Cancer Network, 2016) |
| Minimal | No prophylactic antiemetic (Basch et al., 2011; MASCC/ESMO, 2016; National Comprehensive Cancer Network, 2016) |
aAn NK-1 receptor antagonist should be added for patients with additional risk factors or who are failing 5-HT3 receptor antagonist + dexamethasone (National Comprehensive Cancer Network, 2016). The NK-1 receptor antagonist recommended in the ASCO guidelines is aprepitant (Basch et al., 2011). 5-HT3, 5-hydroxytryptamine type 3; AC, anthracycline–cyclophosphamide; CINV, chemotherapy-induced nausea and vomiting; NK-1, neurokinin-1.